Sarcopenia is a risk factor for postoperative delirium in geriatric hip fracture patients: a retrospective study

Topic: Risk, prevention and care in population studies

Background Various factors contribute to postoperative delirium (POD) in elderly patients undergoing hip fracture surgeries. Sarcopenia was defined as the progressive loss of skeletal muscle mass and strength associated with aging. The aim of this study was to explore the prevalence of POD and sarcopenia in geriatric patients undergoing hip fracture surgeries and to investigate the correlation between preoperative sarcopenia and POD. Methods After applying specific inclusion and exclusion criteria, the information of 234 patients were retrospectively collected. POD was screened for with 4A’s Test and diagnosed with DSM-5 criteria. The incidences of POD and sarcopenia were calculated. The demographic and perioperative features as well as comorbidities of delirious and non-delirious patients were analyzed and the risk factors analysis for POD in elderly hip fracture patients were conducted through univariate analysis and multivariate regression analysis. Results 48.7% patients were diagnosed of POD, 78.95% of which were females. The average age of delirious and non-delirious patients were 84.75 years and 80.63 years, respectively. The incidence of sarcopenia was 41.02% for all the included patients with 60.53% for delirious patients and 20.55% for non-delirious patients. Results of univariate analysis showed that sarcopenia (OR:5.281, 95%CI 2.988–9.337, p = 0.000), age increase per year (OR:1.128, 95CI 1.070–1.190, p = 0.000), operation duration increase (OR:1.017, 95%CI 1.004–1.030, p = 0.011), intertrochanteric fracture (OR:2.571, 95%CI 1.517–4.358, p = 0.000), dementia (OR: 6.029, 95%CI 2.532–14.359, p = 0.000), ASA > 2 (OR: 6.955, 95%CI 3.461–13.976, p = 0.000), coronary heart disease (OR: 2.201, 95%CI 1.257–3.854, p = 0.006), renal insufficiency (OR: 2.215, 95%CI 1.187–4.133, p = 0.012) and COPD (OR: 2.554, 95%CI 1.414–4.615, p = 0.002) were risk factors for POD. Results of multivariate analysis identified sarcopenia (OR: 2.457, 95% CI 1.226–4.923, p = 0.011), ASA > 2 (OR: 3.968, 95% CI 1.805–8.722, p = 0.001), dementia (OR: 3.912, 95% CI 1.390–11.014, p = 0.010) and coronary heart disease (OR: 2.176, 95% CI 1.044–4.538, p = 0.038) as independent risk factors for POD in geriatric hip fracture patients. Conclusion The incidences of POD and sarcopenia in geriatric hip fracture patients are high. Sarcopenia is an independent risk factor for POD in geriatric hip fracture patients.

@article{qi2025-39835112,
  author  = {Qi, Yiming and Li, Hao-Tao and Chang, Shi‐Min and Hu, Sun-Jun and Du, Shou-Chao and Liu, Chen-Dong and Chu, Yong-Qian and Rui, Yunfeng},
  title   = {{Sarcopenia is a risk factor for postoperative delirium in geriatric hip fracture patients: a retrospective study}},
  journal = {Frontiers in Medicine},
  year    = {2025},
  doi     = {10.3389/fmed.2024.1526240},
  pmid    = {39835112},
  url     = {https://doi.org/10.3389/fmed.2024.1526240}
}

Key findings

• Sarcopenia was defined as the progressive loss of skeletal muscle mass and strength associated with aging.
• Results 48.7% patients were diagnosed of POD, 78.95% of which were females.
• Results of univariate analysis showed that sarcopenia (OR:5.281, 95%CI 2.988–9.337, p = 0.000), age increase per year (OR:1.128, 95CI 1.070–1.190, p = 0.000), operation duration increase (OR:1.017, 95%CI 1.004–1.030, p = 0.011), intertrochanteric fracture (OR:2.571, 95%CI 1.517–4.358, p = 0.000), dementia (OR: 6.029, 95%CI 2.532–14.359, p = 0.000), ASA > 2 (OR: 6.955, 95%CI 3.461–13.976, p = 0.000), coronary heart disease (OR: 2.201, 95%CI 1.257–3.854, p = 0.006), renal insufficiency (OR: 2.215, 95%CI 1.187–4.133, p = 0.012) and COPD (OR: 2.554, 95%CI 1.414–4.615, p = 0.002) were risk factors for POD.
• Results of multivariate analysis identified sarcopenia (OR: 2.457, 95% CI 1.226–4.923, p = 0.011), ASA > 2 (OR: 3.968, 95% CI 1.805–8.722, p = 0.001), dementia (OR: 3.912, 95% CI 1.390–11.014, p = 0.010) and coronary heart disease (OR: 2.176, 95% CI 1.044–4.538, p = 0.038) as independent risk factors for POD in geriatric hip fracture patients.

Why it matters

In this retrospective study of older hip fracture patients, sarcopenia before surgery was strongly linked to postoperative delirium. It identifies a risk factor that might be targeted, but reports no treatment or cure for Alzheimer's disease.

Study details

• Participants234
• Effect size48.7%; 78.95%; 41.02%
• Evidence strengthLow

Read the original

• DOI: 10.3389/fmed.2024.1526240
• PubMed: 39835112
• Original source →
• Free full text: Frontiers in Medicine →

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Studies this one cites

Referenced by this study and also in the alzhub library, so you can read them here.

• Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people Age and ageing · 2014-03-02 · usefulness score 61/100 · Getting a diagnosis
• The inter-relationship between delirium and dementia: the importance of delirium prevention Nature reviews. Neurology · 2022-08-26 · usefulness score 59/100 · Prevention and risk
• The DSM-5 criteria, level of arousal and delirium diagnosis: inclusiveness is safer BMC medicine · 2014-10-08 · usefulness score 48/100 · Getting a diagnosis

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